26EHSPMCLMCTGLCRBTRFA: RFA Fee-for-Service Claims for Continuous Glucose Monitoring Products

The Massachusetts Executive Office of Health and Human Services (EOHHS) has issued a Request for Applications (RFA) to establish rebate agreements with manufacturers of continuous glucose monitoring (CGM) products, as existing rebate arrangements are expiring. The primary goal is to secure rebate agreements that facilitate the availability of CGM products through pharmacy channels for MassHealth members and Health Safety Net patients, ensuring continued access to essential diabetes management tools. The solicitation emphasizes the need for fixed Guaranteed Net Unit Prices for each National Drug Code, with the initial contract period set for 24 months starting January 1, 2026, and provisions for potential extensions. Manufacturers are required to submit detailed rebate proposals, including strategies for smooth patient transitions, customer support, and prior Medicaid experience, to participate in this program. The contract size is estimated to range between 5 million and 15 million dollars, reflecting the scale of anticipated product utilization. Supporting documents highlight the framework for rebate agreements, including a State Rebate Agreement that details rebate and pricing terms, and evaluation criteria to assess proposals' clinical benefits, compliance, and strategic approach. The rebate agreements aim to ensure reasonable pricing and facilitate access to CGM products, which are dispensed under both fee-for-service and managed care structures. The procurement process is managed by the Massachusetts Department of Health and Human Services, with a response deadline of October 3, 2025. Interested manufacturers are encouraged to submit comprehensive proposals via the designated procurement portal, with the overarching objective of maintaining affordable, consistent access to vital glucose monitoring devices for eligible populations across the state.